Comparison of effects of nitroprusside and prazosin on left ventricular function and the peripheral circulation in chronic refractory congestive heart failure.

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Abstract
The cardiocirculatory actions of nitroprusside (NP) were compared to prazosin (PZ) in 11 chronic coronary patients with refractory congestive heart failure. Each drug equally lowered systemic arterial pressures mildly, while heart rate was unaltered. NP decline (P < .001) in left ventricular filling pressure (28 to 17 mm Hg) and rise (P < .005) in cardiac index (2.20-2.96 l/min per m2) were similar to PZ (30 to 17) and (2.08 to 3.00). PZ and NP equally enhanced cardiac efficiency of stroke work and myocardial oxygen consumption index. Total systemic vascular resistance declined (P < .001) the same with NP and PZ. Forearm vascular resistance (FVR) and venous tone (FVT) diminished equally with NP and PZ. Similar FVR/FVT percent changes of 0.88 and 0.64 with NP and PZ indicated relatively balanced systemic arteriolovenous relaxation. Since PZ effects persisted 6 h with symptomatic improvement, oral PZ is the best vasodilator for long-term use, extending in-hospital NP-like actions to ambulatory heart failure therapy.

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